The nurse is caring for a child diagnosed with Tetralogy of Fallot. The client has had multiple hypercyanotic episodes (tet spells).
The nurse anticipates that the physician will prescribe
The nurse is caring for a child diagnosed with Tetralogy of Fallot. The client has had multiple hypercyanotic episodes (tet spells).
The nurse anticipates that the physician will prescribe
A. morphine sulfate.
[46%]
B. adenosine.
[15%]
C. diltiazem.
[12%]
D. atropine sulfate.
[26%]
Statistics
Subject/Lesson
Subject
Pharmacology
Lesson
Cardiovascular
Client Need
Test Plan
Pharmacological and Parenteral Therapies
Related Topic
Expected Actions/Outcomes
Item Type
Item Type
Knowledge/Comprehension
Explanation
Choice A is correct. Morphine sulfate is the drug of choice for use during tet spells. It helps calm the child down while reducing the infundibular spasm that causes right ventricular outflow obstruction and, therefore, the hypercyanotic tet spell.
Choice B is incorrect. Adenosine is an antiarrhythmic drug indicated in the treatment of supraventricular tachycardia. This medication would not have an indication in the treatment for a hypercyanotic episode.
Choice C is incorrect. Diltiazem, a calcium channel blocker, would be contraindicated because it would decrease cardiac output, likely worsening the tet spell.
Choice D is incorrect. Atropine sulfate is an anticholinergic. It is used for several purposes, such as treating a slow heart rate or decreasing saliva production before surgery, but not for tet spells.
Related Videos
2 Key Topics
Tetralogy of Fallot (TOF)
31.5 Cyanotic Congenital Heart Defects
Additional Info
✓ A hypercyanotic episode may be triggered by -
- Crying
- Defecation
- Feeding
- Awakening from naps
- Fevers
- Dehydration
- Tachycardia (decreased filling time leads to reduced end-diastolic volume)
- Medications (ACE inhibitors)
✓ Treatment for a tet spell includes positioning the infant in the knee-to-chest position (child have them squat)
✓ Calm the child
✓ Apply supplemental oxygen
✓ Administer prescribed morphine via intravenous push
